A recent publication in The Lancet Global Health underscores the alarming reality that, annually, more than 40 million women worldwide face the risk of enduring persistent health complications stemming from childbirth.
This extensive research, featured as part of a special series on maternal health, brings attention to the significant burden of postnatal conditions that endure for extended periods, often extending beyond the conventional postnatal care timeframe.
The spectrum of issues encompasses dyspareunia (pain during sexual intercourse) affecting 35pc of postpartum women, low back pain (32pc), anal incontinence (19pc), urinary incontinence (8-31pc), anxiety (9-24pc), depression (11-17pc), perineal pain (11pc), fear of childbirth (tokophobia) (6-15pc), and secondary infertility (11pc).
The study's authors advocate for heightened recognition of these prevalent problems within the healthcare system, many of which manifest beyond the traditional postnatal care window. They stress the need for comprehensive care during pregnancy and childbirth to facilitate early detection of risks, thus preventing complications that could result in enduring health challenges after childbirth.
Dr Pascale Allotey, Director of Sexual and Reproductive Health and Research at the World Health Organization (WHO), states, "Many postpartum conditions cause considerable suffering in women's daily lives, both emotionally and physically, long after childbirth. Yet, they remain underappreciated, underrecognized, and underreported. Women need access to a range of services throughout their lives and beyond motherhood, ensuring they not only survive childbirth but also enjoy good health and quality of life."
Despite their prevalence, these conditions have received scant attention in clinical research, practice, and policy. The study's authors discovered a lack of high-quality guidelines for effective treatment of 40pc of the 32 priority conditions analyzed in the past 12 years. Furthermore, not a single high-quality guideline from a low- or middle-income country was identified. The data gaps are glaring, with no nationally representative or global studies available for any of the identified conditions.
The Lancet Series, titled "Maternal Health in the Perinatal Period and Beyond," collectively calls for heightened attention to the long-term health of women and girls, both before and after pregnancy.
The opening paper underscores the need for a holistic approach to reduce maternal deaths, addressing not only immediate biomedical causes but also broader social, economic, and environmental factors impacting women's health, such as racial and gender inequities, economic context, nutrition, sanitation, environmental risks, and exposure to violence and conflict.
Joao Paulo Souza, Centre Director of the Latin American and Caribbean Center on Health Sciences Information (BIREME) for PAHO/WHO and one of the authors of the first paper, says , "Maternal health is not something to be concerned about only during pregnancy. Various factors influence a woman's likelihood of having a healthy pregnancy, from her environment and economic circumstances to her access to nutritious food and agency over her life. All of these factors need to be addressed to improve her health, alongside access to high-quality healthcare throughout her life."
In essence, the Lancet Series advocates for a robust, multidisciplinary healthcare system that not only delivers high-quality and respectful maternity services but also proactively prevents ill health and mitigates the impact of broader inequities, with a focus on supporting the most vulnerable women and girls.